临床路径应用于日间腹股沟疝腹腔镜手术的效果分析

Analysis of Application Effect of Clinical Pathway in Ambulatory Laparoscopic Surgery of Inguinal Hernia

目的了解临床路径应用于日间腹股沟疝腹腔镜手术的效果。方法研究某院自2016年1月-2018年12月行腹腔镜腹股沟疝日间手术232例患者资料,随机分成临床路径组与非临床路径组,进行对比分析。结果随访时间6个月~35个月(中位时间18.6个月),随访率96.1%。两组患者术后4 h疼痛视觉模拟评分(VAS)、术后下床时间、术后急性尿潴留发生率、术后2 w及4 w恢复非限制活动率比较无统计学差异(P>0.05);术后并发症比较无统计学差异(P>0.05),均无严重并发症发生。住院时间、住院总费用临床路径组低于非临床路径组,两组比较有统计学差异(P<0.05)。满意度评分临床路径组高于非临床路径组,两组比较有统计学差异(P<0.05)。结论临床路径应用于日间腹股沟疝腹腔镜手术具有缩短住院时间,降低医疗费用,提高患者满意度等优点,临床路径管理模式是开展日间手术的有力措施。

Objective To investigate the application effect of the clinical pathway in ambulatory laparoscopic surgery of inguinal hernia.Methods The data of 232 patients who underwent ambulatory laparoscopic surgery of inguinal hernia from January 2016 to December 2018 was studied.They were randomly divided into clinical pathway group and non-clinical pathway group for contrastive analysis.Results The follow-up time was 6 to 35 months(median time of 18.6 months),and the follow-up rate was 96.1%.There were no significant differences in postoperative VAS pain score 4 hours,postoperative time out of bed,incidence of postoperative acute urinary retention,and rate of recovery of unrestricted activity 2 and 4 weeks after surgery between the two groups(P>0.05).There was no statistical difference in postoperative complications(P>0.05),and no serious complications occurred.The length of stay and total cost of hospitalization in the clinical pathway group were lower than those in the non-clinical pathway group,and there were statistical differences between the two groups(P<0.05).The satisfaction score of the clinical pathway group was higher than that of the non-clinical pathway group,and there was a statistical difference between the two groups(P<0.05).Conclusion The clinical pathway applied to ambulatory laparoscopic surgery of inguinal hernia has the advantages of shortening the length of hospital stay,reducing medical costs,and improving patient satisfaction.Clinical pathway management model is a powerful measure to develop ambulatory surgery.